Cila blog: In an evolving world, knowledge is key

Over the last 30 years, there has been a revolution in the claims process. The scope of policy cover has widened, and with it an increased awareness of the need to take control of the claim from the earliest possible opportunity so as to manage indemnity spend and provide customer satisfaction.

Coupled with this fundamental change in philosophy, insurers have also sought to reduce the transaction cost of claims, and wherever possible remove redundant ‘file touches’ and their associated costs from the overall claims process. Technical advances have assisted in this process. The role of today’s loss adjuster is very different from that of even 10 years ago.

The modern-day adjuster needs to be able to deploy skills and expertise in a cost-effective and customer-focused manner, and as such the need for continuing professional development and education has never been greater. This is why the Chartered Institute of Loss Adjusters’ technical conference on 14-15 September is focused on ‘Development through knowledge’.

In an increasingly competitive market, leakage is a key area of cost that can be addressed. At the conference, the property and business interruption specialist interest groups will come together to look at overlaps in policy coverage, particularly in the areas of landlord and tenant fittings, to look at the policies that pay, and why.

When leakage crops up, fraud is a topic that soon comes to mind. The ABI reported in 2009 that fraud constituted 13% of retail claims by volume, and 10% by value. It is a growing industry, and fraudsters have become ever more sophisticated. The anti-fraud specialist interest group will explore methods of catching those who intend to defraud insurers and prejudice honest policyholders.

Meanwhile, the developments around contingent fee arrangements have led to a burgeoning of third-party litigation. In part this has been fuelled by intensive TV, radio and newspaper advertising campaigns, and with success fees linked to the Woolf reforms.

As a result, the market in such claims continues to expand, especially where potential claimants face job insecurity and the difficulty of finding alternative employment. To defend these cases, it is imperative that evidence that will stand up to scrutiny of the courts is collected. This allows informed decisions by the defendant insurers at an early stage. The conference will investigate current trends in slips and trips.

Not only are claims trends changing, but they will continue to evolve as legal precedent drives reform. It is vital that all claims professionals remain aware of the evolving legal environment, while technology and the internet can improve a loss adjuster’s access to statute and case law.

These changes need to be placed in context and understood in the wider environment. The liability special interest group will look at significant legal changes over the past year and identify trends that will most affect those dealing with future claims.

These days, the loss adjuster needs knowledge and expertise, coupled with experience and the ability to apply these in new situations. They also need to remain abreast of all of the changes that affect the environment in which they operate.

Graham Burgess is president of the Chartered Institute of Loss Adjusters.